CRC PLEURAL DIS PDF

PREFACE

Pleural diseases present a frequent problem in everyday clinical practice. It is estimated that about 25% of the consultations of a pulmonary service concern pleural diseases. Various medical specialists, including pneumonologists, thoracic surgeons, radiologists, internists, cardiologists, pediatricians, and oncologists, deal with their diagnosis and treatment. However, relatively few scientists and clinicians through their excellent and continuous work have contributed to the advancement of our understanding of the basic and clinical aspects of the pleura in health and disease.

The aim of this book is to provide a comprehensive, authoritative, state-of-the-art presentation of all aspects of pleural diseases by the world's leading authorities. Authors from many countries and renowned institutions contributed to this 51-chapter book, resulting in an international approach to current diagnosis and treatment of pleural diseases, both benign and malignant. I believe that these contributors have given the book a lively flavor, putting the future of the field in an exciting perspective.

Newer techniques, including medical thoracoscopy, pleural lavage, intrapleural fibrinolytics, image-guided small-bore catheters, video-assisted thoracoscopic surgery (VATS), pleuroperitoneal shunt, and extrapleural pneumonectomy are presented in detail. Recent advances in the anatomy, physiology, and pathophysiology of the pleura are presented by experts. The increasing role of imaging techniques, both radiological and ultrasound, in the diagnosis and management of the various pleural diseases is extensively detailed. Interventional techniques for the diagnosis and treatment of pleural diseases, including pleural thoracentesis and closed biopsy, chest tube insertion, pleural lavage, medical thoracoscopy, and VATS, are also elucidated. A critical evaluation of the various diagnostic tests for discrimination between transudates and exudates is elegantly presented. The differentiation of a benign from a malignant pleural effusion is an everyday clinical problem. The importance of clinical evaluation in the differential diagnosis of a pleural effusion is nicely illustrated.

A great deal of this volume is dedicated to pleural infection. A number of experts present their experience in the current diagnosis and management of parapneumonic and surgical pleural infections from both the medical and surgical points of view. The role of newer medical techniques, such as intrapleural instillation of fibrinolytics, the insertion of new, small, image-guided catheters, and medical thoracoscopy are extensively described. Also, the evolution of VATS as a high-priority surgical technique is described and updated.

Tuberculous pleuritis continues to be a major health problem in developing countries and a frequent diagnostic problem in clinical practice. Malignant pleural effusions, primary or metastatic, are an important cause of morbidity, and the various aspects of this condition are presented here. The current understanding and management of mesothelioma and benign asbestos-related pleural disease are presented, together with the interesting technique of extra-pleural pneumonectomy.

The specific characteristics and methods of diagnosis and management of different organ diseases with concomitant pleural disease are also presented in this volume. Pleural effusions in the ICU, in children, and related to drug consumption are included as well. All aspects of pneumothorax, hemothorax, and chylothorax/pseudochylothorax, which represent a continuing challenge to clinicians, are presented. Other chapters deal with undiagnosed persistent pleural effusion, the pleural space in patients having undergone organ transplantation, the pharmacokinetics and pharmacodynamics of the pleural fluid, and animal research models in pleural investigation. Some overlap between the chapters was encouraged, which allowed for an uninterrupted flow of ideas and helped to achieve detailed coverage of the diverse topics.

This book would have been impossible to produce without the help and support of all the distinguished authors, to whom I am profoundly indebted for their contributions. Finally, I am most grateful to my family—Stella, Efrosini, Evangelos, Calliope, Caroline—for their forbearance and continuous support.